胎血MCV、MCH检测在α地中海贫血诊断中的价值

目的探讨产前脐血MCV、MCH特点及参考范围,比较MCV、MCH诊断α地中海贫血(地贫)的价值。方法对1 563例孕妇经腹行脐带穿刺术,取脐血进行血细胞和地贫基因分析,比较MCV、MCH筛查α地贫的灵敏度和特异性等指标。结果α地贫组、正常组脐血MCV和MCH分别为(106.9±10.9)fl、(121.7±8.5)fl和(33.4±4.7)pg、(41.3±2.8)pg,产前脐血MCV和MCH的参考范围为(105.0～138.4)fl和(35.8～46.8)pg。MCH筛查α地贫的灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于MCV,其筛查中间型、重型α地贫灵敏度为100%。结论产前脐血MCV、MCH的参考范围明显高于新生儿及成人,有必要建立参考范围;产前脐血MCV、MCH检测可为α地贫临床诊断提供依据,MCH筛查α地贫优于MCV。

Analysis of fetal blood MCV and MCH in prenatal diagnosis of alpha thalassemia

Objective： To investigate the characteristics and reference range of mean corpuscular volume （MCV） in prenatal umbilical cord blood, mean corpuscular hemoglobin （ MCH）, and the value were compared between MCV and MCH in the diagnosis of thalassemia （thal）. Methods： Cordocentesis were implemented 1 563 cases gravidas, and umbilical cord blood were used to detect the blood cells and thai gene. Results ： MCV and MCH of cord blood were （ 106. 9 ± 10. 9） fl, （ 121.7 ± 8. 5） fl and （33.4 ± 4. 7 ） pg, （41.3 ±2. 8） pg in group of thai and normal respectively. The reference range of MCV and MCH was （ 105 ± 138.4） fl and （35.8 ± 46. 8） pg in prenatal umbilical cord blood. The sensitivity, specificity, accuracy, positive and negative predictive of MCH in screen- ing for alpha thai were higher than those of MCV, and The sensitivity of MCH screening for osculant and major alpha thai were 100%. Conclusion： MCV, MCH of prenatal umbilical cord blood was significantly higher than those of neonatal and adult. It is necessary to establish the reference range of MCV and MCH of umbilical cord blood. To provide a basis for the diagnosis of alpha thala, MCH and MCH should be detected by using umbilical cord blood.